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SANITARY COMMISSION 



New York Agency of the U. S. Sanitary ) 
Commission, 498 BroadvvAy, 

July 21st, 1862. ) 

To the President of the, United States : 

Sir, — Three hundred thousand raw recruits are about to be 
called into the field. It is impossible for the IT. S. Sanitary 
Commission to contemplate this momentous fact without a pro- 
found feeling of its obligation to lend Government whatever 
aid and counsel its peculiar experience may enable it to offer 
as to the safest and best method of getting these men into the 
field and keeping them there in the most serviceable condition 
and with, the highest attainable economy of life and health. 
After studying for fifteen months the sanitary interests of our 
great army, we have arrived at definite conclusions as to mea- 
sures necessary to protect these new levies against certain of 
the dangers that threaten them, and it is our plain duty, as a 
"Commission of inquiry and. advice in regard to the Sanitary 
"interests of the United States Forces," to submit these con- 
elusions, most respectfully, to the consideration of yourself, 
their Commander-in-Chief. 

The careless and superficial medical inspection of recruits 
made at least twenty-five per cent, of the volunteer army raised 
last year, not only utterly useless, but a positive encumbrance 
and embarrassment, filling our Hospitals with invalids and the 
whole country with exaggerated notion^ of the dangers of war 
that now seriously retard the recruiting of the new levies we 



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so urgently need. The wise and humane regulations of the 
United States Army that require a minute and searching in- 
vestigation of the physical condition of every recruit, were 
during the spring and summer of 1861 criminally disregarded 
by Inspecting Officers. In twenty-nine per cent, of the regi- 
ments mustered into service duting that period there had been 
no pretence even of a thorough inspection. Few regiments 
have thus far taken the field that did not include among their 
rank and file many boys of from fou] to sixteen, — men 

with hernia, varicose A T eins, consumption, and other diseases, 
wholly unfitting them for duty, and which could not have 
escaped the eye of a competent Medical Officer — and others 
with constitutions broken by intemperance or disease, or long 
past the age cf military service. Each of these men cost the 
nation a certain amount of money, amounting in the aggregate 
to millions of dollars. Kot one of them was able, however well 
disposed, to endure a week's hardship or render the nation a 
dollar's worth of effective service in the field. Some regiments 
left ten per cent, of their men in hospitals on the road, before 
they reached, the seat of war. !N"o national crisis can excuse 
the recruiting of such material. It increases for a time the 
strength of the army on paper, but diminishes its actual effici- 
ency. It is a mere source of weakness, demoralization, and 
wasteful expense, and of manifold mischief to the army and to 
the [National cause. The frequent spectacle of immature youth 
and men of diseased or enfeebled constitutions returning to their 
homes shattered and. broken down after a month of camp-life 
destructive to themselves and useless to the country, has de- 
pressed the military spirit and confidence of the People. How 1 
can we escape a repetition of this manifest evil except by 
a more vigilant and thorough inspection of our new levies? 
And how can such inspection be secured ? 
We respectfully submit that no new recruits should be ac~ 



cepted until they have been examined by Medical Officers 
of the United States Army, entirely without personal interest 
in the filling- up of any regiment. And these medical men 
should have had some experience in the hardships and expos- 
ures of military life. ]STo one, in short, should be allowed to 
serve as a Medical Inspector of recruits, who has not passed 
a regular Army Board named by the Surgeon-General him- 
self, and convened at some one of the great centres of medical 
science. 

A large percentage of the disease and weakness of our armies 
up to this time, (in other words the waste of many millions of 
our national resources,) has been due to the inexperience of 
Medical and Military Officers alike, as to the peculiar dangers 
and exposures that surround the soldier in camp and on 
the march, and which render the money the nation has ex- 
pended in putting him into the field, a far more precarious 
investment than it would be, were he kept under strict subjec- 
tion to Sanitary Laws. The liability of soldiers to disease 
should be far less than it is. It would be so were they 
required to observe the laws of health. They and their officers, 
and the People and the Government, have thus far too generally 
overlooked those laws. But the last twelve months have taught 
the Army and the People the immense importance of Sanitary 
science in war. Our school has been costly, but it has 
already taught us much. For the last three months 
thousands and thousands of wan and wasted forms brought 
North by railroad, and on Hospital transports, stricken by no 
rebel bullet, but by far deadlier enemies of the Nation — mal- 
arial fever and camp-dysentery — have been impressing on the 
People the lesson the' Sanitary Commission has been endeavor- 
ing to teach ever since the war began, viz., that our soldiers 
were in far greater danger from disease than from the violence 



of their enemies — and that we lose teii men uselessly by pre- 
ventable disease, for every man destroyed by the enemy. 

We have been learning rapidly during the past year. If we 
have learned anything, it has been that it was a mistake to keep 
the Regular Army and the Volunteer Army separate. Had 
the .Regulars been from the first intermingled with the Volun- 
teers, they would have leavened the whole lump witli their ex- 
perience of camp-police, discipline, subordination, and the 
Sanitary conditions of military life. "We should have no Bull 
Run panic to blush for. Our little Regular Army diffused 
among the Volunteers of last year, would within three months 
have brought them up to its own standard of discipline and 
efficiency. 

As it is, the greatest efforts have been required to inspire 
officers and men with a sense of the nature and importance of 
sanitary laws, and with the practical application of hygienic 
principles to their tents, their camps, their persons, and their 
habits and food. In this work, the Sanitary Commission, 
through its professional experts, has labored methodically, and 
with marked success. But it cannot contemplate the needless 
renewal of its painful experience, without warning Government 
that the loss of life by debility, disease, and immaturity — ten 
times that by our bloodiest battles — is wholly unnecessary ; that 
of every ten men lost by the army during the past year, nine 
have been needlessly wasted ; that by proper medical inspec- 
tion of recruits, the material of disease can be reduced to the 
lowest possible sum ; and then, by a proper distribution of the 
raw recruits among the regiments already formed, and of all 
new officers among existing regiments, we may at once com- 
municate all that is most important in the sanitary experi- 
ence of our veteran army to the new levy of 300,000 men, 
and thus save them from seventy-five per cent, of the mortality 
to which they will otherwise be inevitably exposed. 



From a sanitary point of view, the urgency of this policy is 
clear. If all the 300.000 men noio to be recruited, were 
recruited wit/tout a single new regiment being formed, it would 
save the country, sooner or later, thousands of lives, and mil- 
lions of dollars. "We should get a far better class of men. 
They would have a thorough medical inspection, and every 
man would soon cease to be a raw recruit when absorbed into 
a veteran regiment. Thus all our year's costly experience 
would be saved, and the perils of ignorance, inexperience, 
and crudity be avoided. 

This process, too, is that by which our present army can be 
most rapidly reinforced, since the men raised might be sent to 
the field as fast as they were collected, and digested into the 
body of the army, day by day, without delay, and without 
sensibly diluting its discipline. Whereas, raised by regiments, 
as at present, with officers and men equally raw, they must be 
kept in camps of instruction till the pressing want of their ser- 
vices has gone by, or the opportunity of their usefulness is lost. 

If it be said that the stimulus to recruiting will be taken 
away if the aspirations of new officers are repressed, we do 
not hesitate to meet that alternative by saying, that it would 
meet the wants of the country, and the views of an enlightened 
public sentiment better, to draft the whole 300,000 men, with 
a distinct understanding that they were to fill out the skeleton 
regiments to which the army of veterans has become reduced, 
than to have them raised, without drafting, by a volunteer pro- 
cess to which raw officers and unskilled medical men would 
communicate their own ignorance and inadequacy. 

Although it is purely on sanitary grounds that we urge this 
plea, it would be easy to show that military and political wis- 
dom are in exact harmony with sanitary requirements in favor- 
ing such a plan. But we do not venture beyond our own 



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sphere to urge considerations or which others are so much 
better judges. 

If Government will call on the Medical Department of 
the Army for its official judgment on this grave and urgent 
question, we feel no doubt that these views will be abundantly 
confirmed, and more forcibly argued. 
We have the honor to be, 

With great respect, 

Your obedient servants, 

Henry W. Bellows, 

W. II. Van Bttren, M.D., 

C. E. Agnew, M.D., 

WOLCOTT GlBBS, M.D., 

Fkedk. Law Olmsted. 
Geo. T. Strong, 
Exec. Committee of the 

U. S. Sanitary Commission. 



[Note.] 

The following 13 an extract from a Report to the Sanitary 
Commission, by its actuary, Mr. E. B. Elliott, which is now 
in press : 

"Since one hundred and four (104.4) out of every thousand men (officers 
and privates together) in the entire army, is the constant proportion of 
sick, it follows, that, to secure in the field a constant force of fis'e hundred 
thousand (500,000) effective (or healthy and able) men, the nation must 
constantly maintain, in hospitals or elsewhere, an additional force of fifty- 
eight thousand (58,000) sick men, making the entire force maintained, 
both sick and effective, to consist of five hundred and fifty-eight thou- 
sand (558,000) men; four per cent., or 22,000 of this entire force 



would be commissioned officers, and ninety-six per cent., or 536,000 
enlisted men. And since to supply continuous losses in the ranks of the 
enlisted men, other than losses from expiration of service, requires recruits 
at the annual rate of 229 per 1,000 enlisted men, it follows, that to keep 
the ranks of these 536,000 enlisted men constantly full, will require 
annually 123,000 recruits; 29,000 of these recruits being demanded to 
supply the annual loss occasioned by death ; 54,000, the loss arising from 
discharged from service, mainly from disability ; 27,000 for excess of 
desertions over returns of deserters to duty ; 7,000 missing in action, not 
subsequently otherwise accounted for, and 6,000, the loss from other 
causes. 

" To repeat — assuming the returns of the period from the 1st of June, 
1S61, to the 1st of March, 1862, as the basis of calculation, it follows, that 
to secure in the field a constant force of 500,000 effective men, the nation 
must not only maintain 58,000 sick men, but it must also recruit the ranks 
of the enlisted portion of these forces with new material, at the rate of 
123,000 per annum, so long as the war shall last ; a rate somewhat ex- 
ceeding 10,000 recruits per month. Of these 123,000 annual recruits, 
83,000 are to supply losses by death and discharges from service, (ex- 
clusive of discharges for expiration of its term) ; 34,000 for desertions and 
missing in action, (not returned or otherwise accounted for) ; and 6,000 
to supply other losses specified and unspecified. 

" The five hundred thousand (500,000) effective men are equivalent in 
number to the number of men in 573 regiments of the average numerical 
strength, (that is 872 men each) ; and the 58,000 sick equivalent to 67 
regiments of average numerical strength; the entire force of 558,000 men 
to be maintained being equivalent to 640 regiments of average strength." 



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